Janumet XR Extended-Release Tablets (Sitagliptin/Metformin XR)

Janumet XR is a prescription tablet that combines sitagliptin and metformin in an extended-release form for type 2 diabetes. This page summarizes what the medicine does, how it is typically taken, and key safety points from labeling. It also explains access logistics with US shipping from Canada for people paying cash, including those without insurance.

Prescription details may be confirmed with your prescriber when required. The information below is written for general education, so dosing and monitoring should follow the prescribed directions and the official product information. For background on living with this condition, browse the Type 2 Diabetes Hub and related resources.

What Janumet XR Is and How It Works

This medicine contains two glucose-lowering agents in one tablet: sitagliptin (a DPP-4 inhibitor) and metformin (a biguanide). Sitagliptin helps increase incretins (gut hormones that support insulin release after meals) and can reduce glucagon signaling. Metformin mainly decreases liver glucose production and improves insulin sensitivity in peripheral tissues. Together, they are used as part of an overall plan that includes nutrition and activity.

The extended-release formulation releases metformin more slowly across the day. That design can help some people tolerate therapy by spreading exposure over time, though gastrointestinal effects can still occur. Metformin-containing products also carry important safety considerations related to kidney function and conditions that reduce oxygen delivery to tissues.

Why it matters: Many cautions relate to metformin accumulation when the body cannot clear it well.

Who It’s For

Sitagliptin/metformin extended-release tablets are indicated for adults with type 2 diabetes when medication is appropriate alongside diet and exercise. They are not used to treat type 1 diabetes, and they are not a treatment for diabetic ketoacidosis. For browsing similar therapies, see the Diabetes Medications Category and the Non Insulin Medications collection.

High-level situations where this combination may not be suitable include conditions listed as contraindications or major warnings on the label. Common examples include:

• Severely reduced kidney function
• Metabolic acidosis, including diabetic ketoacidosis
• Serious hypersensitivity to components
• Acute illness causing dehydration or poor intake
• Situations with significant hypoxia risk

Some people need closer review before starting therapy, such as those with liver disease, heavy alcohol use, a history of pancreatitis, or older adults with multiple comorbidities. A prescriber may also evaluate other glucose-lowering medicines being used to reduce the chance of low blood sugar.

Dosage and Usage

Janumet XR dosage is prescribed based on prior therapy, kidney function, and tolerability. The extended-release form is typically taken once daily with a meal, but the specific schedule and titration steps should follow the prescription label. Tablets are meant to be swallowed whole; do not split, crush, or chew them unless your prescriber specifically directs otherwise.

How to take extended-release tablets

Extended-release tablets are designed to release medication gradually. Because of that, they should be taken in the form supplied, and they are usually paired with the evening meal or another consistent daily meal to improve tolerability. Some people notice what looks like a “tablet shell” in the stool; this can occur with certain extended-release products and does not necessarily mean the full dose was not absorbed. If gastrointestinal symptoms are persistent, or if doses are frequently missed due to side effects, the prescriber may reassess the regimen rather than changing tablets at home. For deeper background reading, see the Janumet Dosage Guide.

If a dose is missed, labeling for many oral diabetes medicines generally advises taking the next dose as scheduled rather than doubling up, but directions can vary by patient and dose. Use the pharmacy label instructions and contact a pharmacist or prescriber if there is uncertainty about a missed dose or accidental extra dose.

Strengths and Forms

This product is supplied as oral extended-release tablets. In practice, sitagliptin/metformin XR combinations are commonly available in strengths that pair a fixed sitagliptin amount with different metformin XR amounts. Availability can vary by dispensing pharmacy and by country-specific packaging.

When discussing a refill with a pharmacy, it can help to confirm the exact strength and tablet count shown on the prescription, since doses are not interchangeable. Janumet XR tablets may have different imprints by strength, which the dispensing label can clarify.

Orders are dispensed by licensed Canadian pharmacies after the referral step is complete.

Storage and Travel Basics

Store tablets at room temperature in a dry place, away from excess heat and moisture. Keep the medicine in its original container until use, and follow any additional instructions printed on the dispensing label. Bathrooms and cars can expose medicines to humidity or temperature extremes, so a bedroom cabinet or similar dry location is often preferred.

When traveling, keep the medication in carry-on luggage to reduce exposure to temperature swings and to avoid lost baggage. Carry a copy of the prescription or pharmacy label, especially for airport screening or border documentation. If a pill organizer is used, keep the labeled bottle available so the strength and directions can be verified if needed.

Quick tip: Keep an updated medication list on paper for emergencies.

Side Effects and Safety

Like many oral diabetes medicines, Janumet XR can cause side effects that are most noticeable when starting therapy or after dose increases. Commonly reported effects include gastrointestinal upset (nausea, diarrhea, abdominal discomfort), decreased appetite, and headache. Some people also report upper respiratory symptoms; these are not always clearly caused by the medicine, but they are seen in clinical use.

More serious risks require prompt medical attention. Metformin-containing therapies have a boxed warning related to lactic acidosis (a dangerous build-up of lactic acid), which is more likely when kidney function is impaired or during severe illness, dehydration, heavy alcohol intake, or poor oxygenation. Sitagliptin has warnings for pancreatitis and severe hypersensitivity reactions. Low blood sugar is more likely if this therapy is used with insulin or sulfonylureas. For a focused overview, read Janumet Side Effects and explore broader education in Type 2 Diabetes Articles.

Drug Interactions and Cautions

Janumet XR interacts with other medicines mainly through metformin-related clearance and through additive effects on blood glucose. Before starting or refilling, the prescriber and pharmacist typically review prescription drugs, over-the-counter products, and supplements. That review is especially important for therapies that affect kidney function, hydration, or blood glucose.

Common interaction and caution themes include:

• Alcohol use: raises lactic acidosis risk and can destabilize glucose
• Iodinated contrast imaging: may require temporary interruption per prescriber
• Other diabetes drugs: may increase hypoglycemia risk in combinations
• Diuretics or NSAIDs: can worsen kidney function in susceptible patients
• Carbonic anhydrase inhibitors: can increase acidosis risk
• Acute illness: dehydration can increase adverse effects

Because kidney function is central to safe metformin use, any new medication that changes renal perfusion or causes fluid loss should be reviewed. If symptoms suggest pancreatitis (severe abdominal pain, persistent vomiting) or an allergic reaction (swelling, rash, trouble breathing), urgent evaluation is warranted.

Compare With Alternatives

Janumet XR is one of several combination tablets used in type 2 diabetes. Alternatives may be considered when side effects, kidney function, dosing preference, or other medical conditions change. A prescriber may choose to use individual components separately (for example, metformin XR plus a DPP-4 inhibitor) to allow more flexible dose adjustments. For context on related products, the Combination Tablet Category lists multiple options.

Other combination approaches include DPP-4 inhibitor/metformin products such as Jentadueto Combination Tablets, as well as SGLT2 inhibitor/metformin combinations (a different drug class). Some people use metformin alone when appropriate; see Metformin Details for the single-ingredient option. For a plain-language comparison of DPP-4 inhibitor strategies, see Januvia Vs Janumet.

Pricing and Access

Out-of-pocket spending can vary based on strength, quantity, and dispensing fees, so the Janumet XR price without insurance is best reviewed using the exact prescription details. Some people compare combination tablets with separate-component regimens, since the overall total can differ even when the active ingredients are similar. If you are reviewing options, the Diabetes Products listings can help you see related non-insulin therapies in one place.

The platform supports cash-pay access for cross-border prescriptions. Ships from Canada to US, and prescription requirements still apply for regulated medications. If available, promotions may be listed on Promotions, but availability and eligibility can change. Medication supply options and any pickup arrangements depend on the dispensing pharmacy and destination rules.

Authoritative Sources

For the most reliable details on indications, contraindications, and administration instructions, consult the official prescribing information and medication guide. These documents describe warnings for metformin-containing products (including lactic acidosis risk) and sitagliptin-related cautions (including pancreatitis and hypersensitivity).

For the FDA product record and labeling references, see this official listing: FDA Drugs@FDA application overview. For background on one component and its key precautions, this patient-oriented reference is helpful: NIH MedlinePlus metformin monograph.

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This content is for informational purposes only and is not a substitute for professional medical advice.